Don’t put up with Period Pain
Don’t Suffer in Silence
In my clinical practice, I often see women who have suffered in silence with heavy periods (menorrhagia) for many years before seeking treatment.
A recent survey of 1000 women by Hologic UK for the Wear White Again campaign found that around 1 in 5 women are affected but only 38% are aware that heavy menstruation is a medical condition which can be successfully treated by a range of non-surgical and surgical methods, depending on the cause of the condition.
Are you affected by this?
If you dread your periods, avoid social situations and plan your life and activities around them or are constantly worrying about staining your clothing or if you worry about having ‘enough’ sanitary products in your handbag or have to take time off work during your period – like 43% of women in the survey – then there are medical solutions available.
The impact of heavy periods
As well as pelvic pain, low moods, anxiety and a poor sex life, heavy periods can cause anaemia, due to a low blood count. There is also a financial impact. According to the BBC, women spend over £18,000 over their lifetime on sanitary products, pain relief, new underwear and comfort food during their periods. Work time lost due to sick days caused by period pain cannot be ignored, either.
When should you seek medical help?
If your menstrual bleeding interferes with your physical, emotional, social or material quality of life it must be taken seriously. You should also seek medical attention if you have bleeding between periods, after sex and after the menopause. If you keep a diary of your menstrual pain and bleeding this can be very helpful for both you and your doctor.
Who should you see?
Don’t be afraid or too shy to speak to your GP. They will assess your problem and arrange the necessary blood tests and an ultrasound scan to check for fibroids and polyps. Many patients are successfully treated by their GP, who will usually refer you to a gynaecologist if initial treatments don’t work or if further investigations or surgery may be required. You can also ask to see a specialist if you have particular concerns.
The causes of period pain
Half of all patients have no obvious cause. In these cases, it is often a combination of hormonal, blood clotting and womb lining ‘dysfunction’. In a small proportion of patients, thyroid and inherited clotting problems are the cause, and they will usually have other symptoms, too.
Sometimes there may be physical causes, such as fibroids or polyps. Fibroids are common non-cancerous tumours of the womb muscle, found in 4 out of 10 women, whilst polyps are fleshy, benign outgrowths of womb lining. Endometriosis and adenomyosis are both conditions of the uterus which cause more pain than bleeding.
As a general note, always make sure that your cervical smears are up to date and normal.
Your treatment will depend on the cause of your problem and can be tailored to your personal needs and preferences, in discussion with your doctor or gynaecologist.
These can be hormonal or non-hormonal and can be prescribed as tablets, injections or a hormone coil. The contraceptive pill is very effective at regulating periods and reducing bleeding. The Mirena (hormone) coil thins out the womb lining and provides contraception. Non-hormonal treatments are recommended if you are trying to conceive or have chosen not to have hormone treatment.
Surgical options include:
- Hysteroscopy – a camera is used to look at the womb lining and remove polyps or fibroids. This can be done under local or general anaesthetic.
- Myomectomy – under general anaesthetic, fibroids are removed by keyhole (laparoscopic) or open surgery.
- Endometrial ablation – the womb lining is destroyed with radiofrequency energy, under general or local anaesthetic. (Not recommended if you plan to have children).
- Fibroid embolisation – the blood supply to fibroids is blocked off by injecting particles into them, under anaesthetic. (Not recommended if you plan to have children).
- Hysterectomy – last line treatment where the womb is removed by keyhole (laparoscopic) or open surgery. The ovaries can be left in place if you haven’t yet gone through the menopause.
Always remember that medical help is available from your GP and gynaecologists and your treatment can be tailored to suit your personal circumstances. So – don’t suffer in silence, and get your life back to normal.